Behnes M, Mashayekhi K, Borggrefe M, Akin I
I. Medizinische Klinik, Universitätsmedizin Mannheim (UMM), Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Bad Krozingen, Deutschland.
Herz. 2017 Apr;42(2):138-150. doi: 10.1007/s00059-017-4546-5.
Coronary artery disease (CAD) represents a common structural cause for developing cardiac arrest in older patients, whereas in young adults cardiac arrest is more often caused by cardiomyopathies and cardiac channelopathies. A structural heart disease is known in almost 50% of patients prior to cardiac arrest. The present review outlines current interventional and operative therapeutic options for patients surviving cardiac arrest. The focus is on associations between epidemiological data on the incidence of malignant arrhythmias causing cardiac arrest depending on the presence or absence of CAD. Furthermore, the potential benefits of an early coronary revascularization as well as of a prompt complete coronary revascularization compared to the individual treatment of the so-called culprit lesion only are described. Finally, the advantages of invasive therapies for patients surviving cardiac arrest, such as targeted temperature management and mechanical cardiac assist devices, are elucidated. Cardiac assist devices comprise the use of the intra-aortic balloon pump (IABP) and devices for extracorporeal life support (ECLS) for peripheral and central support of the right and left heart chambers.
冠状动脉疾病（CAD）是老年患者发生心脏骤停的常见结构性病因，而在年轻成年人中，心脏骤停更常由心肌病和心脏离子通道病引起。在几乎50%的心脏骤停患者中，心脏骤停前已知存在结构性心脏病。本综述概述了心脏骤停幸存者目前的介入和手术治疗选择。重点在于根据是否存在CAD，分析导致心脏骤停的恶性心律失常发生率的流行病学数据之间的关联。此外，还描述了早期冠状动脉血运重建以及与仅对所谓罪犯病变进行个体化治疗相比迅速进行完全冠状动脉血运重建的潜在益处。最后，阐明了针对心脏骤停幸存者的侵入性治疗的优势，如目标温度管理和机械心脏辅助装置。心脏辅助装置包括使用主动脉内球囊泵（IABP）以及用于体外生命支持（ECLS）的装置，以对左右心腔进行外周和中心支持。
